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E. M. Palkovacs, K. Golnik; Idiopathic Bilateral Iris Atrophy. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1461.
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We report 2 patients who developed bilateral symmetric, non-reactive, mydriatic pupils with 360 degrees of iris transillumination defects after respiratory illnesses and subsequent antibiotic use. Both patients had pupils that were non-reactive to light or accommodation with no response when challenged with 2% Pilocarpine, suggesting iris sphincter end-organ damage. Both patients were female, in their late 50’s to early 60’s, and had been treated with the oral fluoroquinolone, Moxifloxacin, for pneumonia several months prior to developing symptoms. Neither patient had any prior history of herpetic eye disease, previous trauma, heterochromia, glaucoma, or ocular inflammation.
Extensive PubMed English language literature search.
No reported cases in the literature of antibiotic use leading to iris end-organ damage, or post-infectious causes.
We conclude that either a new presentation of a post-infectious syndrome or a side-effect of antibiotic use resulted in bilateral symmetric iris sphincter damage in two patients.
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